Director, Quality Operations

About This Role

This Director, Quality Operations role involves developing and implementing an effective and robust PACE quality program to ensure Welbe Health participants receive unique care. The Director oversees Quality Operations activities, leads Quality Operations teams, and communicates quality results to various stakeholders, while continuously identifying education and training opportunities to improve team member performance.

Responsibilities

• Collaborate with the VP, Quality Operations to develop and standardize enterprise metrics in clinical excellence, quality, and patient safety in alignment with all policies and procedures, as well as local, state, federal, and CDC guidelines
• Collaborate with the VP, Quality Operations and other Directors, Quality Operations to develop standardized quality operations workflows, playbooks, tools, and other quality operations resources, as well as to implement standardized and scalable approaches to collecting data, analyzing data, and generating data visualizations and reports
• Partner with Analytics and Performance Excellence Teams to analyze and review operational performance for continuous process improvements, increased efficiency, and participant satisfaction
• Monitor and analyze data including quality improvement (QI) plan metrics, HPMS entries, company and market initiatives, and corrective action plans (CAPs) to identify trends and areas for process improvement
• Act as a QI subject matter expert on program and company initiatives as needed, such as collaborating with the Compliance team on initiatives to monitor and improve compliance issues, CAPs, and the Fraud, Waste, and Abuse program
• Collaborate with the Quality Operations team and Compliance Officer to ensure PACE program complaints are appropriately investigated, responded to, and documented, as well as support PACE program procedures to process grievances and complaints in accordance with applicable state and federal regulations, policies and procedures, and compliance standards
• Ensure complete and timely submission of all information required by regulatory agencies including but not limited to HPMS

Benefits

• Medical insurance coverage (Medical, Dental, Vision)
• 17 days of personal time off (PTO)
• 12 holidays observed annually
• 6 sick days
• 401K savings + match
• Comprehensive compensation package including bonus

Important Details

• Locations: Remote, CA, USA (Candidates must reside in California, preferably in Northern California or within a 2-hour direct flight of Sacramento, with the ability to travel onsite as needed for business and regulatory requirements)

About the Company

At Welbe Health, the company serves communities’ most vulnerable seniors through shared intention, pioneering spirit, and the courage to love. These core values and participant-focus lead the way no matter what. Welbe Health leads enterprise-wide quality strategy and compliance excellence, driving the design, implementation, and continuous improvement of the PACE quality program, directly impacting participant safety, regulatory readiness, and care outcomes. It partners cross-functionally to turn data into action, collaborating with Analytics, Compliance, and Operations teams to translate complex data into actionable insights, strengthen performance, and elevate quality across the organization.